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Getting B12 levels into normal range or overrange does not magically fix this damage overnight, it takes a lot of work - nerves regrow at 1mm a day for example, and often levels need to be maintained at very high ranges to alleviate symptoms
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In some patients, using biotin alone may trigger a recurrence of the acute crisis, so biotin is usually combined with thiamine [67]
Some individuals report developing acne after starting B12 supplements or injections, raising questions about this potential side effect
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